Skip to main content
Top
Published in: Pituitary 1/2017

01-02-2017

Acromegalic osteopathy

Authors: G. Mazziotti, F. Maffezzoni, S. Frara, A. Giustina

Published in: Pituitary | Issue 1/2017

Login to get access

Abstract

Acromegalic osteopathy is an emerging complication of acromegaly characterized by increase in bone turnover, deterioration in bone microarchitecture and high risk of vertebral fractures. Vertebral fractures, as diagnosed by a radiological and morphometric approach, occur in about one-third of acromegaly patients in close relationship with duration of active disease. However, the prediction of vertebral fractures in this clinical setting is still a matter of uncertainty, since the pathogenesis of acromegalic osteopathy is multifactorial and fractures may occur even in presence of normal bone mineral density. In this narrative article, we summarize the pathophysiology and clinical aspects of acromegalic osteopathy.
Literature
2.
go back to reference Mazziotti G, Bianchi A, Bonadonna S, Nuzzo M, Cimino V, Fusco A, De Marinis L, Giustina A (2006) Increased prevalence of radiological spinal deformities in adult patients with GH deficiency: influence of GH replacement therapy. J Bone Miner Res 21:520–528CrossRefPubMed Mazziotti G, Bianchi A, Bonadonna S, Nuzzo M, Cimino V, Fusco A, De Marinis L, Giustina A (2006) Increased prevalence of radiological spinal deformities in adult patients with GH deficiency: influence of GH replacement therapy. J Bone Miner Res 21:520–528CrossRefPubMed
3.
go back to reference Wuster C, Abs R, Bengtsson BA, Bennmarker H, Feldt-Rasmussen U, Hernberg-Ståhl E, Monson JP, Westberg B, Wilton P, KIMS Study Group and the KIMS International Board. Pharmacia and Upjohn International Metabolic Database (2001) The influence of growth hormone deficiency, growth hormone replacement therapy, and other aspects of hypopituitarism on fracture rate and bone mineral density. J Bone Miner Res 16:398–405CrossRefPubMed Wuster C, Abs R, Bengtsson BA, Bennmarker H, Feldt-Rasmussen U, Hernberg-Ståhl E, Monson JP, Westberg B, Wilton P, KIMS Study Group and the KIMS International Board. Pharmacia and Upjohn International Metabolic Database (2001) The influence of growth hormone deficiency, growth hormone replacement therapy, and other aspects of hypopituitarism on fracture rate and bone mineral density. J Bone Miner Res 16:398–405CrossRefPubMed
4.
go back to reference Giustina A, Mazziotti G (2015) Growth hormone replacement therapy and fracture risk. Lancet Diabetes Endocrinol 3:307–308CrossRefPubMed Giustina A, Mazziotti G (2015) Growth hormone replacement therapy and fracture risk. Lancet Diabetes Endocrinol 3:307–308CrossRefPubMed
5.
go back to reference Mazziotti G, Doga M, Frara S, Maffezzoni F, Porcelli T, Cerri L, Maroldi R, Giustina A (2016) Incidence of morphometric vertebral fractures in adult patients with growth hormone deficiency. Endocrine 52:103–110CrossRefPubMed Mazziotti G, Doga M, Frara S, Maffezzoni F, Porcelli T, Cerri L, Maroldi R, Giustina A (2016) Incidence of morphometric vertebral fractures in adult patients with growth hormone deficiency. Endocrine 52:103–110CrossRefPubMed
6.
go back to reference Albright F, Reifenstein EC (1948) The Parathyroid Glands and Metabolic Bone Disease. Williams and Wilkins, Baltimore Albright F, Reifenstein EC (1948) The Parathyroid Glands and Metabolic Bone Disease. Williams and Wilkins, Baltimore
7.
go back to reference Mazziotti G, Chiavistelli S, Giustina A (2015) Pituitary diseases and bone. Endocrinol Metab Clin North Am 44:171–180CrossRefPubMed Mazziotti G, Chiavistelli S, Giustina A (2015) Pituitary diseases and bone. Endocrinol Metab Clin North Am 44:171–180CrossRefPubMed
8.
go back to reference Halse J, Melsen F, Mosekilde L (1981) Iliac crest bone mass and remodeling in acromegaly. Acta Endocrinol 97:18–22PubMed Halse J, Melsen F, Mosekilde L (1981) Iliac crest bone mass and remodeling in acromegaly. Acta Endocrinol 97:18–22PubMed
9.
go back to reference Riggs L, Randall RV, Wanner HW, Jowsey J, Kelly PJ, Singh M (1972) The nature of metabolic bone disorder in acromegaly. J Clin Endocrinol Metab 34:911–918CrossRefPubMed Riggs L, Randall RV, Wanner HW, Jowsey J, Kelly PJ, Singh M (1972) The nature of metabolic bone disorder in acromegaly. J Clin Endocrinol Metab 34:911–918CrossRefPubMed
10.
go back to reference Kayath MJ, Vieira JG (1997) Osteopenia occurs in a minority of patients with acromegaly and is predominant in the spine. Osteoporos Int 7:226–230CrossRefPubMed Kayath MJ, Vieira JG (1997) Osteopenia occurs in a minority of patients with acromegaly and is predominant in the spine. Osteoporos Int 7:226–230CrossRefPubMed
11.
go back to reference Vestergaard P, Mosekilde L (2004) Fracture risk is decreased in acromegaly–a potential beneficial effect of growth hormone. Osteoporos Int 15:155–159CrossRefPubMed Vestergaard P, Mosekilde L (2004) Fracture risk is decreased in acromegaly–a potential beneficial effect of growth hormone. Osteoporos Int 15:155–159CrossRefPubMed
12.
go back to reference Madeira M, Neto LV, de Paula Paranhos Neto F, Barbosa Lima IC, Carvalho de Mendonça LM, Gadelha MR, Fleiuss de Farias ML (2013) Acromegaly has a negative influence on trabecular bone, but not on cortical bone, as assessed by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 98:1734–1741CrossRefPubMed Madeira M, Neto LV, de Paula Paranhos Neto F, Barbosa Lima IC, Carvalho de Mendonça LM, Gadelha MR, Fleiuss de Farias ML (2013) Acromegaly has a negative influence on trabecular bone, but not on cortical bone, as assessed by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 98:1734–1741CrossRefPubMed
13.
go back to reference Maffezzoni F, Maddalo M, Frara S, Mezzone M, Zorza I, Baruffaldi F, Doglietto F, Mazziotti G, Maroldi R, Giustina A (2016) Cone beam tomography analysis of bone microarchitecture in patients with acromegaly and vertebral fractures. Endocrine. doi:10.1007/s12020-016-1078-3 Maffezzoni F, Maddalo M, Frara S, Mezzone M, Zorza I, Baruffaldi F, Doglietto F, Mazziotti G, Maroldi R, Giustina A (2016) Cone beam tomography analysis of bone microarchitecture in patients with acromegaly and vertebral fractures. Endocrine. doi:10.​1007/​s12020-016-1078-3
14.
go back to reference Mazziotti G, Biagioli E, Maffezzoni F, Spinello M, Serra V, Maroldi R, Floriani I, Giustina A (2015) Bone turnover, bone mineral density, and fracture risk in acromegaly: a meta-analysis. J Clin Endocrinol Metab 100:384–394CrossRefPubMed Mazziotti G, Biagioli E, Maffezzoni F, Spinello M, Serra V, Maroldi R, Floriani I, Giustina A (2015) Bone turnover, bone mineral density, and fracture risk in acromegaly: a meta-analysis. J Clin Endocrinol Metab 100:384–394CrossRefPubMed
15.
go back to reference Canalis E, Giustina A, Bilezikian JP (2007) Mechanisms of anabolic therapies for osteoporosis. N Engl J Med 357:905–916CrossRefPubMed Canalis E, Giustina A, Bilezikian JP (2007) Mechanisms of anabolic therapies for osteoporosis. N Engl J Med 357:905–916CrossRefPubMed
16.
go back to reference Mazziotti G, Bilezikian J, Canalis E, Cocchi D, Giustina A (2012) New understanding and treatments for osteoporosis. Endocrine 41:58–69CrossRefPubMed Mazziotti G, Bilezikian J, Canalis E, Cocchi D, Giustina A (2012) New understanding and treatments for osteoporosis. Endocrine 41:58–69CrossRefPubMed
17.
go back to reference Kassem M, Blum W, Ristelli J, Mosekilde L, Eriksen EF (1993) Growth hormone stimulates proliferation and differentiation of normal human osteoblast-like cells in vitro. Calcif Tissue Int 52:222–226CrossRefPubMed Kassem M, Blum W, Ristelli J, Mosekilde L, Eriksen EF (1993) Growth hormone stimulates proliferation and differentiation of normal human osteoblast-like cells in vitro. Calcif Tissue Int 52:222–226CrossRefPubMed
18.
go back to reference DiGirolamo DJ, Mukherjee A, Fulzele K, Gan Y, Cao X, Frank SJ, Clemens TL (2007) Mode of growth hormone action in osteoblasts. J Biol Chem 282:31666–31674CrossRefPubMed DiGirolamo DJ, Mukherjee A, Fulzele K, Gan Y, Cao X, Frank SJ, Clemens TL (2007) Mode of growth hormone action in osteoblasts. J Biol Chem 282:31666–31674CrossRefPubMed
19.
go back to reference Stĕpán J, Marek J, Havránek T, Dolezal V, Pacovský V (1979) Bone isoenzyme of serum alkaline phosphatase in acromegaly. Clin Chim Acta 93:355–363CrossRefPubMed Stĕpán J, Marek J, Havránek T, Dolezal V, Pacovský V (1979) Bone isoenzyme of serum alkaline phosphatase in acromegaly. Clin Chim Acta 93:355–363CrossRefPubMed
20.
go back to reference Scillitani A, Chiodini I, Carnevale V, Giannatempo GM, Frusciante V, Villella M, Pileri M, Guglielmi G, Di Giorgio A, Modoni S, Fusilli S, Di Cerbo A, Liuzzi A (1997) Skeletal involvement in female acromegalic subjects: the effects of growth hormone excess in amenorrheal and menstruating patients. J Bone Miner Res 12:1729–1736CrossRefPubMed Scillitani A, Chiodini I, Carnevale V, Giannatempo GM, Frusciante V, Villella M, Pileri M, Guglielmi G, Di Giorgio A, Modoni S, Fusilli S, Di Cerbo A, Liuzzi A (1997) Skeletal involvement in female acromegalic subjects: the effects of growth hormone excess in amenorrheal and menstruating patients. J Bone Miner Res 12:1729–1736CrossRefPubMed
21.
go back to reference Ueland T, Bollerslev J, Godang K, Müller F, Frøland SS, Aukrust P (2001) Increased serum osteoprotegerin in disorders characterized by persistent immune activation or glucocorticoid excess–possible role in bone homeostasis. Eur J Endocrinol 145:685–690CrossRefPubMed Ueland T, Bollerslev J, Godang K, Müller F, Frøland SS, Aukrust P (2001) Increased serum osteoprotegerin in disorders characterized by persistent immune activation or glucocorticoid excess–possible role in bone homeostasis. Eur J Endocrinol 145:685–690CrossRefPubMed
22.
go back to reference Claessen KM, Mazziotti G, Biermasz NR, Giustina A (2016) Bone and Joint Disorders in Acromegaly. Neuroendocrinology 103:86–95CrossRefPubMed Claessen KM, Mazziotti G, Biermasz NR, Giustina A (2016) Bone and Joint Disorders in Acromegaly. Neuroendocrinology 103:86–95CrossRefPubMed
23.
go back to reference Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A, McClung M, Morris HA, Silverman S, Trenti T, Wahl DA, Cooper C, Kanis JA (2011) Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 22:391–420CrossRefPubMed Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A, McClung M, Morris HA, Silverman S, Trenti T, Wahl DA, Cooper C, Kanis JA (2011) Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 22:391–420CrossRefPubMed
24.
go back to reference Kamenický P, Mazziotti G, Lombès M, Giustina A, Chanson P (2014) Growth hormone, insulin-like growth factor-1, and the kidney: pathophysiological and clinical implications. Endocr Rev 35:234–281CrossRefPubMed Kamenický P, Mazziotti G, Lombès M, Giustina A, Chanson P (2014) Growth hormone, insulin-like growth factor-1, and the kidney: pathophysiological and clinical implications. Endocr Rev 35:234–281CrossRefPubMed
25.
go back to reference Halupczok-Żyła J, Jawiarczyk-Przybyłowska A, Bolanowski M (2015) Patients with active acromegaly are at righ risk of 25(OH)D deficiency. Front Endocrinol 6:89 Halupczok-Żyła J, Jawiarczyk-Przybyłowska A, Bolanowski M (2015) Patients with active acromegaly are at righ risk of 25(OH)D deficiency. Front Endocrinol 6:89
26.
go back to reference Ajmal A, Haghshenas A, Attarian S, Barake M, Tritos NA, Klibanski A, Miller KK, Nachtigall LB (2014) The effect of somatostatin analogs on vitamin D and calcium concentrations in patients with acromegaly. Pituitary 17:366–373CrossRefPubMed Ajmal A, Haghshenas A, Attarian S, Barake M, Tritos NA, Klibanski A, Miller KK, Nachtigall LB (2014) The effect of somatostatin analogs on vitamin D and calcium concentrations in patients with acromegaly. Pituitary 17:366–373CrossRefPubMed
27.
go back to reference Mazziotti G, Maffezzoni F, Giustina A (2016) Vitamin D-binding protein: one more piece in the puzzle of acromegalic osteopathy? Endocrine 52:183–186CrossRefPubMed Mazziotti G, Maffezzoni F, Giustina A (2016) Vitamin D-binding protein: one more piece in the puzzle of acromegalic osteopathy? Endocrine 52:183–186CrossRefPubMed
28.
go back to reference Altinova AE, Ozkan C, Akturk M, Gulbahar O, Yalcin M, Cakir N, Toruner FB (2016) Vitamin D-binding protein and free vitamin D concentrations in acromegaly. Endocrine 52:374–379CrossRefPubMed Altinova AE, Ozkan C, Akturk M, Gulbahar O, Yalcin M, Cakir N, Toruner FB (2016) Vitamin D-binding protein and free vitamin D concentrations in acromegaly. Endocrine 52:374–379CrossRefPubMed
29.
go back to reference Mazziotti G, Cimino V, De Menis E, Bonadonna S, Bugari G, De Marinis L, Veldhuis JD, Giustina A (2006) Active acromegaly enhances spontaneous parathyroid hormone pulsatility. Metabolism 55:736–740CrossRefPubMed Mazziotti G, Cimino V, De Menis E, Bonadonna S, Bugari G, De Marinis L, Veldhuis JD, Giustina A (2006) Active acromegaly enhances spontaneous parathyroid hormone pulsatility. Metabolism 55:736–740CrossRefPubMed
30.
go back to reference Schousboe JT, Shepherd JA, Bilezikian JP, Baim S (2013) Executive summary of the 2013 international society for clinical densitometry position development conference on bone densitometry. J Clin Densitom 16:455–466CrossRefPubMed Schousboe JT, Shepherd JA, Bilezikian JP, Baim S (2013) Executive summary of the 2013 international society for clinical densitometry position development conference on bone densitometry. J Clin Densitom 16:455–466CrossRefPubMed
31.
go back to reference Ueland T, Fougner SL, Godang K, Schreiner T, Bollerslev J (2006) Serum GH and IGF-I are significant determinants of bone turnover but not bone mineral density in active acromegaly: a prospective study of more than 70 consecutive patients. Eur J Endocrinol 155:709–715CrossRefPubMed Ueland T, Fougner SL, Godang K, Schreiner T, Bollerslev J (2006) Serum GH and IGF-I are significant determinants of bone turnover but not bone mineral density in active acromegaly: a prospective study of more than 70 consecutive patients. Eur J Endocrinol 155:709–715CrossRefPubMed
32.
go back to reference Diamond T, Nery L, Posen S (1989) Spinal and peripheral bone mineral densities in acromegaly: the effects of excess growth hormone and hypogonadism. Ann Intern Med 111:567–573CrossRefPubMed Diamond T, Nery L, Posen S (1989) Spinal and peripheral bone mineral densities in acromegaly: the effects of excess growth hormone and hypogonadism. Ann Intern Med 111:567–573CrossRefPubMed
33.
go back to reference Lesse GP, Fraser WD, Farquharson R, Hipkin L, Vora JP (1998) Gonadal status is an important determinant of bone density in acromegaly. Clin Endocrinol 48:59–65CrossRef Lesse GP, Fraser WD, Farquharson R, Hipkin L, Vora JP (1998) Gonadal status is an important determinant of bone density in acromegaly. Clin Endocrinol 48:59–65CrossRef
34.
go back to reference Griffith JF, Genant HK (2012) New advances in imaging osteoporosis and its complications. Endocrine 42:39–51CrossRefPubMed Griffith JF, Genant HK (2012) New advances in imaging osteoporosis and its complications. Endocrine 42:39–51CrossRefPubMed
35.
go back to reference Lim SV, Marenzana M, Hopkinson M, List EO, Kopchick JJ, Pereira M, Javaheri B, Roux JP, Chavassieux P, Korbonits M, Chenu C (2015) Excessive growth hormone expression in male GH transgenic mice adversely alters bone architecture and mechanical strength. Endocrinology 156:1362–1371CrossRefPubMedPubMedCentral Lim SV, Marenzana M, Hopkinson M, List EO, Kopchick JJ, Pereira M, Javaheri B, Roux JP, Chavassieux P, Korbonits M, Chenu C (2015) Excessive growth hormone expression in male GH transgenic mice adversely alters bone architecture and mechanical strength. Endocrinology 156:1362–1371CrossRefPubMedPubMedCentral
36.
go back to reference Ueland T, Ebbesen EN, Thomsen JS, Mosekilde L, Brixen K, Flyvbjerg A, Bollerslev J (2002) Decreased trabecular bone biomechanical competence, apparent density, IGF-II and IGFBP-5 content in acromegaly. Eur J Clin Invest 32:122–128CrossRefPubMed Ueland T, Ebbesen EN, Thomsen JS, Mosekilde L, Brixen K, Flyvbjerg A, Bollerslev J (2002) Decreased trabecular bone biomechanical competence, apparent density, IGF-II and IGFBP-5 content in acromegaly. Eur J Clin Invest 32:122–128CrossRefPubMed
37.
go back to reference Mazziotti G, Canalis E, Giustina A (2010) Drug-induced osteoporosis: mechanisms and clinical implications. Am J Med 123:877–884CrossRefPubMed Mazziotti G, Canalis E, Giustina A (2010) Drug-induced osteoporosis: mechanisms and clinical implications. Am J Med 123:877–884CrossRefPubMed
38.
go back to reference Mazziotti G, Porcelli T, Mormando M, De Menis E, Bianchi A, Mejia C, Mancini T, De Marinis L, Giustina A (2011) Vertebral fractures in males with prolactinoma. Endocrine 39:288–293CrossRefPubMed Mazziotti G, Porcelli T, Mormando M, De Menis E, Bianchi A, Mejia C, Mancini T, De Marinis L, Giustina A (2011) Vertebral fractures in males with prolactinoma. Endocrine 39:288–293CrossRefPubMed
39.
go back to reference Angeli A, Guglielmi G, Dovio A, Capelli G, de Feo D, Giannini S, Giorgino R, Moro L, Giustina A (2006) High prevalence of asymptomatic vertebral fractures in post-menopausal women receiving chronic glucocorticoid therapy: a cross-sectional outpatient study. Bone 39:253–259CrossRefPubMed Angeli A, Guglielmi G, Dovio A, Capelli G, de Feo D, Giannini S, Giorgino R, Moro L, Giustina A (2006) High prevalence of asymptomatic vertebral fractures in post-menopausal women receiving chronic glucocorticoid therapy: a cross-sectional outpatient study. Bone 39:253–259CrossRefPubMed
40.
go back to reference Mazziotti G, Delgado A, Maffezzoni F, Formenti A, Giustina A (2016) Skeletal Fragility in Endogenous Hypercortisolism. Front Horm Res 46:66–73CrossRefPubMed Mazziotti G, Delgado A, Maffezzoni F, Formenti A, Giustina A (2016) Skeletal Fragility in Endogenous Hypercortisolism. Front Horm Res 46:66–73CrossRefPubMed
41.
go back to reference Ulivieri FM, Silva BC, Sardanelli F, Hans D, Bilezikian JP, Caudarella R (2014) Utility of the trabecular bone score (TBS) in secondary osteoporosis. Endocrine 47:435–448CrossRefPubMed Ulivieri FM, Silva BC, Sardanelli F, Hans D, Bilezikian JP, Caudarella R (2014) Utility of the trabecular bone score (TBS) in secondary osteoporosis. Endocrine 47:435–448CrossRefPubMed
42.
go back to reference Hong AR, Kim JH, Kim SW, Kim SY, Shin CS (2016) Trabecular bone score as a skeletal fragility index in acromegaly patients. Osteoporos Int 27:1123–1129CrossRefPubMed Hong AR, Kim JH, Kim SW, Kim SY, Shin CS (2016) Trabecular bone score as a skeletal fragility index in acromegaly patients. Osteoporos Int 27:1123–1129CrossRefPubMed
43.
go back to reference Godang K, Olarescu NC, Bollerslev J, Heck A (2016) Treatment of acromegaly increases BMD but reduces trabecular bone score: a longitudinal study. Eur J Endocrinol 175:155–164CrossRefPubMed Godang K, Olarescu NC, Bollerslev J, Heck A (2016) Treatment of acromegaly increases BMD but reduces trabecular bone score: a longitudinal study. Eur J Endocrinol 175:155–164CrossRefPubMed
44.
go back to reference Vestergaard P, Jørgensen JO, Hagen C, Hoeck HC, Laurberg P, Rejnmark L, Brixen K, Weeke J, Andersen M, Conceicao FL, Nielsen TL, Mosekilde L (2002) Fracture risk is increased in patients with GH deficiency or untreated prolactinomas—a case-control study. Clin Endocrinol (Oxf) 56:159–167CrossRef Vestergaard P, Jørgensen JO, Hagen C, Hoeck HC, Laurberg P, Rejnmark L, Brixen K, Weeke J, Andersen M, Conceicao FL, Nielsen TL, Mosekilde L (2002) Fracture risk is increased in patients with GH deficiency or untreated prolactinomas—a case-control study. Clin Endocrinol (Oxf) 56:159–167CrossRef
45.
go back to reference Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ III (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227CrossRefPubMed Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ III (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227CrossRefPubMed
46.
go back to reference Genant HK, Jergas M, Palermo L, Nevitt M, Valentin RS, Black D, Cummings SR (1996) Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis the Study of Osteoporotic Fractures Research Group. J Bone Miner Res 11:984–996CrossRefPubMed Genant HK, Jergas M, Palermo L, Nevitt M, Valentin RS, Black D, Cummings SR (1996) Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis the Study of Osteoporotic Fractures Research Group. J Bone Miner Res 11:984–996CrossRefPubMed
47.
go back to reference Bonadonna S, Mazziotti G, Nuzzo M, Bianchi A, Fusco A, De Marinis L, Giustina A (2005) Increased prevalence of radiological spinal deformities in active acromegaly: a cross-sectional study in postmenopausal women. J Bone Miner Res 20:1837–1844CrossRefPubMed Bonadonna S, Mazziotti G, Nuzzo M, Bianchi A, Fusco A, De Marinis L, Giustina A (2005) Increased prevalence of radiological spinal deformities in active acromegaly: a cross-sectional study in postmenopausal women. J Bone Miner Res 20:1837–1844CrossRefPubMed
48.
go back to reference Mazziotti G, Bianchi A, Bonadonna S, Cimino V, Patelli I, Fusco A, Pontecorvi A, De Marinis L, Giustina A (2008) Prevalence of vertebral fracture in men with acromegaly. J Clin Endocrinol Metab 93:4649–4655CrossRefPubMed Mazziotti G, Bianchi A, Bonadonna S, Cimino V, Patelli I, Fusco A, Pontecorvi A, De Marinis L, Giustina A (2008) Prevalence of vertebral fracture in men with acromegaly. J Clin Endocrinol Metab 93:4649–4655CrossRefPubMed
49.
go back to reference Battista C, Chiodini I, Muscarella S, Guglielmi G, Mascia ML, Carnevale V, Scillitani A (2009) Spinal volumetric trabecular bone mass in acromegalic patients: a longitudinal study. Clin Endocrinol 70:378–382CrossRef Battista C, Chiodini I, Muscarella S, Guglielmi G, Mascia ML, Carnevale V, Scillitani A (2009) Spinal volumetric trabecular bone mass in acromegalic patients: a longitudinal study. Clin Endocrinol 70:378–382CrossRef
50.
go back to reference Wassenaar MJ, Biermasz NR, Hamdy NA, Zillikens MC, van Meurs JB, Rivadeneira F, Hofman A, Uitterlinden AG, Stokkel MP, Roelfsema F, Kloppenburg M, Kroon HM, Romijn JA, Pereira AM (2011) High prevalence of vertebral fractures despite normal bone mineral density in patients with long-term controlled acromegaly. Eur J Endocrinol 164:475–483CrossRefPubMed Wassenaar MJ, Biermasz NR, Hamdy NA, Zillikens MC, van Meurs JB, Rivadeneira F, Hofman A, Uitterlinden AG, Stokkel MP, Roelfsema F, Kloppenburg M, Kroon HM, Romijn JA, Pereira AM (2011) High prevalence of vertebral fractures despite normal bone mineral density in patients with long-term controlled acromegaly. Eur J Endocrinol 164:475–483CrossRefPubMed
51.
go back to reference Padova G, Borzì G, Incorvaia L, Siciliano G, Migliorino V, Vetri M, Tita P (2011) Prevalence of osteoporosis and vertebral fractures in acromegalic patients. Clin Cases Miner Bone Metab 8:37–43PubMedPubMedCentral Padova G, Borzì G, Incorvaia L, Siciliano G, Migliorino V, Vetri M, Tita P (2011) Prevalence of osteoporosis and vertebral fractures in acromegalic patients. Clin Cases Miner Bone Metab 8:37–43PubMedPubMedCentral
52.
go back to reference Brzana J, Yedinak CG, Hameed N, Fleseriu M (2014) FRAX score in acromegaly: does it tell the whole story? Clin Endocrinol 80:614–616CrossRef Brzana J, Yedinak CG, Hameed N, Fleseriu M (2014) FRAX score in acromegaly: does it tell the whole story? Clin Endocrinol 80:614–616CrossRef
53.
go back to reference Madeira M, Neto LV, Torres CH, de Mendonça LM, Gadelha MR, de Farias ML (2013) Vertebral fracture assessment in acromegaly. J Clin Densitom 16:238–243CrossRefPubMed Madeira M, Neto LV, Torres CH, de Mendonça LM, Gadelha MR, de Farias ML (2013) Vertebral fracture assessment in acromegaly. J Clin Densitom 16:238–243CrossRefPubMed
54.
go back to reference Mazziotti G, Bianchi A, Porcelli T, Mormando M, Maffezzoni F, Cristiano A, Giampietro A, De Marinis L, Giustina A (2013) Vertebral fractures in patients with acromegaly: a 3-year prospective study. J Clin Endocrinol Metab 98:3402–3410CrossRefPubMed Mazziotti G, Bianchi A, Porcelli T, Mormando M, Maffezzoni F, Cristiano A, Giampietro A, De Marinis L, Giustina A (2013) Vertebral fractures in patients with acromegaly: a 3-year prospective study. J Clin Endocrinol Metab 98:3402–3410CrossRefPubMed
55.
go back to reference Claessen KM, Kroon HM, Pereira AM, Appelman-Dijkstra NM, Verstegen MJ, Kloppenburg M, Hamdy NA, Biermasz NR (2013) Progression of vertebral fractures despite long-term biochemical control of acromegaly: a prospective follow-up study. J Clin Endocrinol Metab 98:4808–4815CrossRefPubMed Claessen KM, Kroon HM, Pereira AM, Appelman-Dijkstra NM, Verstegen MJ, Kloppenburg M, Hamdy NA, Biermasz NR (2013) Progression of vertebral fractures despite long-term biochemical control of acromegaly: a prospective follow-up study. J Clin Endocrinol Metab 98:4808–4815CrossRefPubMed
56.
go back to reference Mazziotti G, Gola M, Bianchi A, Porcelli T, Giampietro A, Cimino V, Doga M, Gazzaruso C, De Marinis L, Giustina A (2011) Influence of diabetes mellitus on vertebral fractures in men with acromegaly. Endocrine 40:102–108CrossRefPubMed Mazziotti G, Gola M, Bianchi A, Porcelli T, Giampietro A, Cimino V, Doga M, Gazzaruso C, De Marinis L, Giustina A (2011) Influence of diabetes mellitus on vertebral fractures in men with acromegaly. Endocrine 40:102–108CrossRefPubMed
57.
go back to reference Mazziotti G, Porcelli T, Bianchi A, Cimino V, Patelli I, Mejia C, Fusco A, Giampietro A, De Marinis L, Giustina A (2010) Glucocorticoid replacement therapy and vertebral fractures in hypopituitary adult males with GH deficiency. Eur J Endocrinol 163:15–20CrossRefPubMed Mazziotti G, Porcelli T, Bianchi A, Cimino V, Patelli I, Mejia C, Fusco A, Giampietro A, De Marinis L, Giustina A (2010) Glucocorticoid replacement therapy and vertebral fractures in hypopituitary adult males with GH deficiency. Eur J Endocrinol 163:15–20CrossRefPubMed
58.
go back to reference Mazziotti G, Mormando M, Cristiano A, Bianchi A, Porcelli T, Giampietro A, Maffezzoni F, Serra V, De Marinis L, Giustina A (2014) Association between l-thyroxine treatment, GH deficiency, and radiological vertebral fractures in patients with adult-onset hypopituitarism. Eur J Endocrinol 170:893–899CrossRefPubMed Mazziotti G, Mormando M, Cristiano A, Bianchi A, Porcelli T, Giampietro A, Maffezzoni F, Serra V, De Marinis L, Giustina A (2014) Association between l-thyroxine treatment, GH deficiency, and radiological vertebral fractures in patients with adult-onset hypopituitarism. Eur J Endocrinol 170:893–899CrossRefPubMed
59.
go back to reference Johansson H, Odén A, McCloskey EV, Kanis JA (2014) Mild morphometric vertebral fractures predict vertebral fractures but not non-vertebral fractures. Osteoporos Int 25:235–241CrossRefPubMed Johansson H, Odén A, McCloskey EV, Kanis JA (2014) Mild morphometric vertebral fractures predict vertebral fractures but not non-vertebral fractures. Osteoporos Int 25:235–241CrossRefPubMed
60.
go back to reference Giustina A, Casanueva FF, Cavagnini F, Chanson P, Clemmons D, Frohman LA, Gaillard R, Ho K, Jaquet P, Kleinberg DL, Lamberts SW, Lombardi G, Sheppard M, Strasburger CJ, Vance ML, Wass JA, Melmed S (2003) Diagnosis and treatment of acromegaly complications. J Endocrinol Invest 26:1242–1247CrossRefPubMed Giustina A, Casanueva FF, Cavagnini F, Chanson P, Clemmons D, Frohman LA, Gaillard R, Ho K, Jaquet P, Kleinberg DL, Lamberts SW, Lombardi G, Sheppard M, Strasburger CJ, Vance ML, Wass JA, Melmed S (2003) Diagnosis and treatment of acromegaly complications. J Endocrinol Invest 26:1242–1247CrossRefPubMed
61.
go back to reference Melmed S, Casanueva FF, Klibanski A, Bronstein MD, Chanson P, Lamberts SW, Strasburger CJ, Wass JA, Giustina A (2013) A consensus on the diagnosis and treatment of acromegaly complications. Pituitary 16:294–302CrossRefPubMed Melmed S, Casanueva FF, Klibanski A, Bronstein MD, Chanson P, Lamberts SW, Strasburger CJ, Wass JA, Giustina A (2013) A consensus on the diagnosis and treatment of acromegaly complications. Pituitary 16:294–302CrossRefPubMed
62.
go back to reference Ben-Shlomo A, Sheppard MC, Stephens JM, Pulgar S, Melmed S (2011) Clinical, quality of life, and economic value of acromegaly disease control. Pituitary 14:284–294CrossRefPubMedPubMedCentral Ben-Shlomo A, Sheppard MC, Stephens JM, Pulgar S, Melmed S (2011) Clinical, quality of life, and economic value of acromegaly disease control. Pituitary 14:284–294CrossRefPubMedPubMedCentral
63.
go back to reference Crespo I, Webb SM (2014) Perception of health and cognitive dysfunction in acromegaly patients. Endocrine 46:365–367CrossRefPubMed Crespo I, Webb SM (2014) Perception of health and cognitive dysfunction in acromegaly patients. Endocrine 46:365–367CrossRefPubMed
64.
go back to reference Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, Kanis J (2000) Health related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392CrossRefPubMed Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, Kanis J (2000) Health related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392CrossRefPubMed
65.
go back to reference Giustina A, Bronstein MD, Casanueva FF, Chanson P, Ghigo E, Ho KK, Klibanski A, Lamberts S, Trainer P, Melmed S (2011) Current management practices for acromegaly: an international survey. Pituitary 14:125–133CrossRefPubMed Giustina A, Bronstein MD, Casanueva FF, Chanson P, Ghigo E, Ho KK, Klibanski A, Lamberts S, Trainer P, Melmed S (2011) Current management practices for acromegaly: an international survey. Pituitary 14:125–133CrossRefPubMed
66.
go back to reference Giustina A, Mazziotti G, Torri V, Spinello M, Floriani I, Melmed S (2012) Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS One 7:e36411CrossRefPubMedPubMedCentral Giustina A, Mazziotti G, Torri V, Spinello M, Floriani I, Melmed S (2012) Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS One 7:e36411CrossRefPubMedPubMedCentral
67.
go back to reference Maison P, Tropeano AI, Macquin-Mavier I, Giustina A, Chanson P (2007) Impact of somatostatin analogs on the heart in acromegaly: a metaanalysis. J Clin Endocrinol Metab 92:1743–1747CrossRefPubMed Maison P, Tropeano AI, Macquin-Mavier I, Giustina A, Chanson P (2007) Impact of somatostatin analogs on the heart in acromegaly: a metaanalysis. J Clin Endocrinol Metab 92:1743–1747CrossRefPubMed
68.
go back to reference Neggers SJ, van Aken MO, de Herder WW, Feelders RA, Janssen JA, Badia X, Webb SM, van der Lely AJ (2008) Quality of life in acromegalic patients during long-term somatostatin analog treatment with and without pegvisomant. J Clin Endocrinol Metab 93:3853–3859CrossRefPubMed Neggers SJ, van Aken MO, de Herder WW, Feelders RA, Janssen JA, Badia X, Webb SM, van der Lely AJ (2008) Quality of life in acromegalic patients during long-term somatostatin analog treatment with and without pegvisomant. J Clin Endocrinol Metab 93:3853–3859CrossRefPubMed
69.
go back to reference Mazziotti G, Marzullo P, Doga M, Aimaretti G, Giustina A (2015) Growth hormone deficiency in treated acromegaly. Trends Endocrinol Metab 26:11–21CrossRefPubMed Mazziotti G, Marzullo P, Doga M, Aimaretti G, Giustina A (2015) Growth hormone deficiency in treated acromegaly. Trends Endocrinol Metab 26:11–21CrossRefPubMed
70.
go back to reference Frara S, Maffezzoni F, Mazziotti G, Giustina A (2016) The modern criteria for medical management of acromegaly. Prog Mol Biol Transl Sci 138:63–83CrossRefPubMed Frara S, Maffezzoni F, Mazziotti G, Giustina A (2016) The modern criteria for medical management of acromegaly. Prog Mol Biol Transl Sci 138:63–83CrossRefPubMed
71.
go back to reference Giustina A, Bevan JS, Bronstein MD, Casanueva FF, Chanson P, Petersenn S, Thanh XM, Sert C, Houchard A, Guillemin I, Melmed S, SAGIT Investigator Group (2016) SAGIT®: clinician-reported outcome instrument for managing acromegaly in clinical practice development and results from a pilot study. Pituitary 19:39–49CrossRefPubMed Giustina A, Bevan JS, Bronstein MD, Casanueva FF, Chanson P, Petersenn S, Thanh XM, Sert C, Houchard A, Guillemin I, Melmed S, SAGIT Investigator Group (2016) SAGIT®: clinician-reported outcome instrument for managing acromegaly in clinical practice development and results from a pilot study. Pituitary 19:39–49CrossRefPubMed
Metadata
Title
Acromegalic osteopathy
Authors
G. Mazziotti
F. Maffezzoni
S. Frara
A. Giustina
Publication date
01-02-2017
Publisher
Springer US
Published in
Pituitary / Issue 1/2017
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-016-0758-6

Other articles of this Issue 1/2017

Pituitary 1/2017 Go to the issue